Board of Health

CITY OF SALEM BOARD OF HEALTH MEETING MINUTES Virtual Meeting held via Zoom and Recorded by SATV February 9, 2021 MEMBERS PRESENT: Dr. Jeremy Schiller, Paul Kirby, Geraldine Yuhas, Sara Moore, Datanis Elias OTHERS PRESENT: David Greenbaum, Health Agent, Maureen Davis, Clerk of the Board, Patricia Morsillo, City Council Liaison ATTENDEES ADDRESSED: Alan Hanscom, SATV and resident, Steven Kapantais, resident TOPIC DISCUSSION/ACTION J. Schiller read aloud that, pursuant to Governor Baker’s orders, there exists COVID-19 Emergency Open Meeting Law Guidance regarding the implementation of virtual public meetings, etc. 1. Call to Order 7:03pm 2. Approval of Minutes G. Yuhas motioned to approve the minutes. P. Kirby 2 nd. All in favor. (December 17, 2020 and Motion passed. January 12, 2021) 3. Updates on COVID-19 D. Greenbaum reported that case counts are coming down. We have daily case counts as low as 5-10 and as high as 20-25, which is down considerably from the last several weeks. Salem returned to a yellow community status on Thursday because our percent positivity fell below five. The big news is that vaccines are rolling out. We did first responders in early January and moved to other phase 1 priority groups in mid-to-late January, such as home healthcare workers and congregate group homes. On February 1st the Governor opened up phase 2 with the first priority group being seniors 75 years and older. We did an initial clinic for them on Friday. We are having a hard time getting Moderna vaccine, but we have been able to get plenty of Pfizer vaccine so that’s what we used. This week we are doing second doses of Moderna for first responders. Next week we will start to go to the five communities’ councils on aging to vaccinate more seniors 75+. Starting tomorrow, Cataldo Ambulance will take over the Salem State University South Campus site and do vaccinations as well. There appears to be plenty of Pfizer vaccine, so we will use that as we go forward until the supply of Moderna becomes more readily available. J. Schiller asked how many vaccines per day we are giving out on average. D. Greenbaum said we are averaging 200-225 right now. The State has told local health that we are not the primary provider of vaccines. People should be looking at the mass vaccine sites like Gillette, Fenway, the Doubletree Inn in Danvers, and other locations the State will be setting up. They should be looking at pharmacies and their doctor’s offices. Our role is to fill in some gaps and maybe do some senior housing facilities, etc. 1|Page The communities that we have dealt with, including Beverly, Danvers, Marblehead, and Swampscott, feel strongly about doing some vaccination clinics at the senior centers in their towns and communities. He does not disagree with that. He thinks it is important that people know we are there. The good thing is that those clinics won’t be just for the residents of that city or town, it will be for the residents of all five communities. We will provide the clinic information to the councils on aging so they can assist people in getting signed up. It will also help to get some equity in the number of appointments each community is getting. J. Schiller asked if there have been any bottlenecks with the supply of vaccine and the resources to administer. D. Greenbaum said no, it has been matched pretty well. We have a good group of volunteers called the Medical Reserve Corps. We have had some really great volunteers working at our clinics so far and the clinics have been very well run. J. Schiller said he communicated with D. Greenbaum and offered to help with administering vaccines if there is a need. He asked if any other members were interested. G. Yuhas also offered to help after she receives her second dose tomorrow. D. Greenbaum thanked them and said if we need help in any way we will reach out. J. Schiller said in looking at the situation report the decrease in active cases and case positivity per day is dramatically lower. However, if you look at the ICU capacity and hospitalizations it is lower than it has been, but it is still pretty high. The important point is that at least it is heading in the right direction. D. Greenbaum said it is important to reiterate that while vaccines are rolling out and there does appear to be some light at the end of the tunnel, we should still be doing all the mitigation efforts we have been doing for the last 10 months. We should still be wearing face coverings, social distancing, not gathering in large crowds and washing hands frequently. The goal of the vaccine is to reach herd immunity and we want to vaccinate 85% of the population to get there. If we can bring the positivity rates and the case rates down and then get the immunization rates up then we, as a community and as a country overall, will be in good shape. J. Schiller reiterated a point that what was made earlier at one of our meetings; as the positivity rate goes down, the vaccines actually become more effective. We need to continue to do what’s right until we get to a better place. S. Moore asked about the testing sites and when they will end. She also inquired about the testing for Salem residents at the CLC. D. Greenbaum said the Stop the Spread testing sites at Old Town Hall and Salem High School will run through March 31 st. The timeframes are given to us by the State, however every time we were given an end date for Stop the Spread testing it has been extended by at least a couple of months. He can’t make any guarantees, but he anticipates that we will see an extension at some point. The City was paying for testing at the CLC, but it has stopped, and he doesn’t think it will be continuing. Attendee Alan Hanscom, Washington Square, asked what it means that as the positivity rates go down the vaccine gets more effective. D. Greenbaum said we know not everybody is going to get vaccinated, but there is a direct correlation between immunization rates going up and 2|Page  infection rates going down and the effectiveness of the vaccine on the community overall. J. Schiller told D. Greenbaum that as things play out to just let the Board know if there is any role we can play. D. Greenbaum said probably as we get to more broad-scale clinics and mass vaccinations we will be reaching out for assistance. G. Yuhas asked if people should still get tested after they have been vaccinated. D. Greenbaum said it is still a good idea to get tested because we know the vaccine is not a cure. You can still contract the virus even if you’ve been vaccinated. Even if the vaccine minimizes your symptoms, or you have no symptoms at all, you can still transmit the virus to someone who has not been vaccinated. J. Schiller said at least we are seeing positive trends compared to where we were two months ago when we were at a real critical stage, but in no way should we be letting our guard down. D. Greenbaum said hopefully the Superbowl doesn’t create an uptick in cases. That will be determined in the next week to ten days. 4. Discussion on Health Disparities S. Moore said she did ask the question whether or not the Latin X and Race Equity community in particular had any hesitation about getting the vaccine. Ana Nuncio said she didn’t think so. Most of the people she talked to in the Latin X community are excited about getting it. J. Schiller asked how often the subcommittee meets. S. Moore said they meet every Friday at 3:00pm. They decided to keep the survey they were using to collect data open a little bit longer. She plans to be at the meeting this week. 5. Chairperson Communications J. Schiller said our primary focus has been COVID. 6. Monthly Reports-Updates a. Public Health Nurse’s Report Report not available. D. Greenbaum reported that our Public Health Nurse, Suzanne Darmody, is finishing up our first responder clinic so she was not able to join us for the meeting. J. Schiller asked how Suzanne is doing. D. Greenbaum said she is hanging in there. There has been some nervousness around the vaccines. They are very fragile, and storage and handling has been a concern, not just for us but across a lot of communities dealing with this. We are primarily getting Pfizer at this point and we have been able to work with the hospital to store it for us in their ultra-cold freezer. When we need doses, we let them know how many vials we need, they prep them and get them ready for us and we pick them up. It takes about three hours for Pfizer to thaw, but Suzanne saw that it thawed quite a bit faster than that. It shouldn’t be a problem. J. Schiller asked how many vaccinations are in a vial. D. Greenbaum said Pfizer is five doses, but a lot of times you can get six. Moderna is ten doses per vial. Sometimes you can get an eleventh dose, but it is not as consistent as getting a sixth dose from Pfizer. P. Kirby asked if there are any concerns with getting second doses of the 3|Page  same brand name as first doses. D. Greenbaum said the State is telling us we are guaranteed to get second dose vaccines, no matter what brand it is. We were able to get all the doses we needed for this week’s second dose clinics. You can get a second dose up to four days before the 28th day after a first dose, but there is no maximum number of days in which to receive second doses after the 28 th day. You can even go a month after. P. Kirby said to give Suzanne our thanks. Attendee Steve Kapantais, 23 Wisteria Street, thanked the Board for all they are doing through COVID-19. He asked what the lead time is for appointment dates for vaccinations. D. Greenbaum said we are not booking out any appointments too far in advance. We are scheduling clinics and advertising them as they go up. Our appointments will go up generally a week in advance. People can sign up the week prior and even on that day if appointments are still available. If somebody comes without an appointment, we take their name and number and if we have vaccine left, we give them a call and they can come and get their dose. We have had some people do that. S. Kapantais asked if the Salem State site is up and running yet. He said at the Salem State site there is nothing available until after March 8 th. D. Greenbaum said the Salem State site was up and running last week with the City running it. Starting tomorrow Cataldo will be running it. He recommended he check the City’s website for the link or contact the Council on Aging and they can help people make appointments if there are still some available. He believes Cataldo will be expanding to multiple days and times in the coming weeks. b. Health Agent’s Report D. Greenbaum said he will continue to provide the weekly situation report to the Board. c. Administrative Report Copy available at BOH office. J. Schiller asked when the budget is due. D. Greenbaum said he hasn’t received budget information yet. We generally see them in February or March. He imagines it will be due sometime in late March or early April for review and meetings with the Mayor and Finance Director and then in front of the City Council probably sometime in June. d. Council Liaison Updates P. Morsillo reported the Accessory Dwelling Unit (ADU) ordinance will be reintroduced on Thursday. The State just passed their housing choice bill which eliminates the super majority required for zoning changes. The ordinance will go to the Planning Board first, then there will be public hearings with the Planning Board and the City Council together. We will hopefully get more housing created. ADU is a gentle growth with no big construction sites. They can create low rent apartments for people, which is exactly what we need. On an unrelated note, on February 17th there will be an appeal before the Zoning Board of Appeals for a request to open a gun shop on 1 Florence Street, which is off Canal Street behind the Salem Car Wash. It is an R3 zoned area. She wanted to bring it to our attention to see if the Board would be interested in writing a letter. Before she was on the City Council, she was the Chair of the League of Women Voters in Salem’s working 4|Page group on gun safety. Before the pandemic started, they had been planning to work with the Board of Health to introduce things like inexpensive gun locks for people who own guns to keep their guns locked. It wouldn’t cost them anything, and it would make it safer. They had been lobbying at the State level for bills related to gun safety and for a State-level criminal database to help track data on guns. Hearing that there might be a gun store opened up in Salem really raises a lot of concern on her part. J. Schiller asked if there are any more gun shops in Salem. S. Moore said she heard on social media that there are a couple of people who have the ability to sell firearms, but they have not done so. She echoes P. Morsillo’s concerns since we do occasionally see firearm violence in Salem. P. Morsillo said for the ZBA, the new use is not supposed to be more harmful or detrimental to the public than the current use. The current use is a doggy daycare. We are talking about mental health issues during the pandemic, and the majority of gun deaths are from suicide, not street violence. She just doesn’t think it is an appropriate use for that location in Salem in the time we’re in. J. Schiller recalled that a number of years ago the Board signed onto a petition with the State about the importance of the awareness of gun violence. P. Kirby said we did, and it was around the issue of allowing CDC funds to be used for research. J. Schiller said it was also about doctor-patient relationships and asking about gun safety and gun use. He said gun violence is clearly a Board of Health issue. P. Kirby said he would be in favor of the Board intervening on the side of not allowing a gun shop in Salem. J. Schiller asked what the Board can do to be useful. We can highlight the statistics of suicide, etc. P. Morsillo suggested they could write a letter or speak to the ZBA at the meeting on February 17th because it is a public hearing. Attendee Alan Hanscom said he is worried about this and asked what kind of guns they would be selling and how powerful the guns are. It would be scary if they would be selling assault weapons. P. Morsillo said all she has is an agenda item about a firearms retail business. P. Kirby said he believes it is illegal to sell any automatic weapons in MA. There was discussion among members about the process of getting the letter(s) to the ZBA. J. Schiller suggested it might have impact if each member wrote individual letters about how they feel about it. D. Greenbaum said he will send Board members an email with the ZBA membership and they can email their letters directly to them. Attendee Steve Kapantais said Bob’s on North Street and David Frank’s on Bridge Street were the last two gun shops in Salem. He doesn’t know if either one is still actively open or selling. They still may have a license, so that is something the Board can check with the City. He suggested the Board do their homework if they are going to be offering gun locks for safety because there are many that are not useful, at all. There is no doubt that suicide is something the Board of Health needs to be concerned with. 60% of death rates by gun fall into the category of suicide. However, he 5|Page has concerns when he hears comments like we don’t want a gun store in Salem, followed by a statement that you can’t buy semi-automatic guns in MA – which is not true. This is a commerce business and to try to make a correlation that, because you have a gun store in your town, it is even tangentially responsible for suicide deaths is a concern. He has issues with a Board that is supposed to be dealing with Board of Health issues trying to deal with things that are constitutionally protected, not just for owners but for commerce. J. Schiller said it is a point well taken. That’s why he thinks contacting the ZBA individually and letting them know how we feel concerned about it would be better. It is not about targeting a specific business as much as it is about raising the issue of how the Board of Health views guns in the paradigm of public health. It is something we have weighed in on in the past. It’s not necessarily this gun shop, but guns in general are dangerous and they are a public health issue and are under the purview of the Board of Health. That, coupled with the pandemic and the stress on mental health, is a real issue. He agrees with S. Kapantais that this gun shop is a commerce issue, and that’s why it is not coming before the Board of Health. The issues of guns do fall under a public health issue and we are well within our jurisdiction to weigh in on that or to provide education on that. P. Kirby said he apologized for being a little emotional. He grew up in a town in Texas that is famous for mass shootings, so he has really strong personal feelings about guns. However, he agrees with J. Schiller that there is a really robust public health argument around the proliferation of guns. S. Moore asked P. Morsillo to articulate what it means that the person who is wanting to open the store is going before the ZBA to request a special permit. P. Morsillo said it means it is not allowed in an R3 zoned area, which is a multi-unit residential area. In order to gain the approval from the ZBA, they have to show that it’s not more harmful or detrimental to the public than the current use. P. Kirby said so by going before the ZBA they are asking for an exception, but if you applied the rule as written, the answer would be no. P. Morsillo said she is just explaining the process for the ZBA. It is not a business zone. S. Moore said the City still has opportunities to decide where business is located, for instance, marijuana dispensaries, so there is some regulation of commerce. It is not surprising that there might be some concern around this issue. She agrees with J. Schiller that gun violence is under the purview of the Board of Health. It’s a public health issue – it just is. J. Schiller encouraged everyone on the Board to try to get on to the ZBA meeting next week. D. Greenbaum said four or five years ago a lot of boards of health signed on to a letter that went to the Governor declaring gun violence as a public health concern. He was working in Saugus at the time and the Saugus Board of Health also signed onto it, as he believes Salem did. He will send a copy of the letter to the Board. P. Kirby thanked S. Kapantais for speaking on this issue. P. Kirby moved to approve the reports. G. Yuhas 2 nd. All in favor. Motion passed. 6|Page  7. New Business/Scheduling of Future G. Yuhas asked if we are going to follow Boston and open things up to Agenda Items 40%. D. Greenbaum said we did follow Boston and the Governors order to increase capacities to 40%. At this point in time the numbers show that things are going in the right direction and there would be no justification to be more restrictive. Should the numbers change, then the Board should absolutely discuss being more restrictive if the Governor doesn’t do it for the State. J. Schiller pointed out that it is important to remember that where we were in December was based on the data. The most compelling data was the trend in positive cases, the local lack of capacity at the hospital and input from local hospital presidents at Beverly and Salem saying they were nearing zero capacity. That is the big criteria. That’s the most critical data we look to when deciding whether or not to open up more. We now have more room in the hospital, but that doesn’t mean we should be less vigilant about being socially distanced and wearing masks, etc. What should scare us most is when the hospitals lack capacity to treat us – that’s a problem. D. Elias said she would like to educate herself more before she discusses the gun issue in a public forum. MEETING ADJOURNED: S. Moore motioned to adjourn. P. Kirby 2 nd. All in favor. Motion passed. 7:50pm Respectfully submitted, Maureen Davis Next regularly scheduled meeting is Clerk of the Board Tuesday, March 9, 2021 at 7:00pm Virtual Meeting Via Zoom 7|Page